Worst Ways to Put Out Your Eyes

June 30, 2008

By ALLYSON T. COLLINSABC News Medical Unit

Back in October 2003, Thomas Cosma and his neighbor were clearing a fallen tree from his backyard in Stockholm, N.J. The neighbor was cutting the branches with a chainsaw, while Cosma was dragging away the debris.

Without warning, one of the branches whipped back at Cosma. It sliced the front of his right eye, causing a hyphema -- bleeding inside the eye. He says he didn't feel pain, but he was immediately unable to see.

Cosma eventually required surgery at the New York Eye and Ear Infirmary to repair his eye. On the night of his surgery, he says, he heard of at least two other eye injury operations slated for that same evening. One of his fellow patients had been hit in the eye with a paperclip. The other had been struck by a piece of flying metal while walking through Home Depot.

Cosma's experience is consistent with the 2008 Eye Injury Snapshot, a new survey released by the American Academy of Ophthalmology, which reports that 45 percent of eye injuries occur at home. And while the upcoming Fourth of July weekend has many Americans concerned over fireworks-related eye injuries, research shows that more often than not, simple around-the-house activities are to blame.

What's worse, even though nearly 90 percent of eye injuries in the survey were classified as preventable with proper eyewear, more than three out of four of those injured were not wearing eyewear at the time of injury.

"Home sweet home is not home safe home," says Dr. Andrew Iwach, spokesman for the AAO.

Fortunately, Cosma's vision returned to normal after the surgery. Under the insistence of his daughters, he now wears one of two sets of goggles during his yard-work -- one that has tinted shades for sun protection, or the other, whichhas clear lenses for indoor work. Each cost him about $10 at a home and garden store.

Since the survey's findings, the AAO is now recommending that every household keep a pair of protective eyewear certified by the American National Standards Institute -- meaning that the glasses are strong enough to resist impact.

"If you don't have them available, the odds are you won't use them," says Iwach.

What You Don't Know Can Hurt You

In addition to checking with doctors, the AAO also surveyed 801 American adults to get their impressions of eye injuries. Only 10 percent believed they were at a high risk.

"There is a disconnect between the perceptions of the public and what we're actually seeing," Iwach says.

Eye injuries are the second highest cause of visual impairment in the United States. Every year, more than 2.5 million eye injuries occur, causing 50,000 people to permanently lose vision.

In their survey, the AAO looked at 765 eye injuries reported by 775 doctors in a two-week period. Researchers found that several activities accounted for most of the at-home injuries:

Play or Sports

"One of the more common sports injuries is to be poked by a finger when playing basketball," says Dr. Matthew Gardiner, director of ophthalmology emergency services at the Massachusetts Eye and Ear Infirmary. The other typical sports injury includes the ball-to-the-eye, whether it be a baseball, golf ball, squash ball or racquetball.

As with most eye injuries, "a lot of these injuries are so easily preventable just by avoiding the activity or wearing eyewear," Gardiner says.

Of course, some sports just don't lend themselves to heavy-duty protective gear -- a fact that Gardiner acknowledges. "I don't expect people to go to the golf course with helmets on," he says.

Nonetheless, even shatterproof sunglasses can protect the eyes during sports.

Yard Work or Yard Power Tools

"Some of our worst injuries that we see are with lawn mowers and weed eaters," says Dr. James Banta, medical director of emergency ophthalmology at Bascom Palmer Eye Institute in Miami.

Both tools send debris flying at high velocities, and can easily end up in the eye.

"It's absolutely vitally important that if you're doing these things, the appropriate eye protection is worn," Banta says.

This goes for people standing nearby as well. "It's not necessarily the man who's pushing the lawn mower that gets hit," says Dr. Dean Eliott, professor and director of the Doheny Retina Institute in Los Angeles. "Sometimes it's the child who is playing on the patio."

Therefore, Iwach advises, people should be aware that there are two ways to be at risk of eye injury: "One is doing something, and the other is being near it."

Power Tools and Home Repair

These types of injuries have become more common recently, says Dr. John Aljian, chief of eye trauma at The New York Eye and Ear Infirmary.

"Now that we're into this home-improvement craze ... people try to do stuff on their own," he says.

Like yard tools, fast-moving saws or high-velocity drills can send particles flying -- straight into the eye. These particles can remain on the surface of the eye, or even penetrate the front of the eye and end up inside the eyeball, Eliott says.

Objects that enter the eye cause the most serious injuries. "Not only because of the traumatic damage that the particle does but because the particle can be contaminated with bacteria and cause an infection in the eye," he says.

Avoiding such trauma is easy. "Anytime anyone picks up a tool at home, they have to put on safety glasses, no matter how simple the task might be," Aljian says.

Fireworks

While most Americans in the AAO survey believed fireworks were the third-leading cause of eye injuries, they actually rank at the bottom -- even below makeup and toy-related injuries.

Still, about 1,400 people do sustain eye injuries from fireworks every year, according to the Consumer Product Safety Commission.

In January 2004, 8-year-old Joshua Lazcano was one of them. He was in his front yard in Hollywood, Fla., watching his brothers and neighbors play with fireworks. In an instant, one of the lit fireworks accidentally landed in his eye.

"He came up to me and was screaming, 'Mom, I can't see! I'm blind!" remembers his mother, Rhonda Lazcano. Later, doctors determined that his lens has shattered. The boy eventually developed a cataract.

Banta performed surgery on Lazcano a few months later, and today the 13-year-old is able to see just fine. But Lazcano was lucky, as the incident easily could have blinded him.

"Fireworks should be observed from a safe distance and performed by professionals," Banta says.

Treatment Tips

For any eye injury that involves a cut or an object that penetrates the eye, it's essential to leave the injury alone.

"You don't touch, rub or apply pressure to the eye, period," says Banta. "Don't put any medication or ointment in it, and if something is stuck, don't remove it."

Pain medications are out as well. The proper treatment is to shield the eye and go immediately to the emergency room, Banta says.

Chemical injuries can also occur at home. Compounds in cleaning products can damage the delicate tissues of the eye.

"With any chemical injury, the most important thing is to flush the eye, and that begins at home," Banta says.

If an eyewash solution is handy, that's preferred for flushing the eye, he says.

But that's not always possible, which "basically means putting your head under a water faucet if that's the only thing you can do," Eliott says. "Do whatever you can to irrigate the eye for as long as you can."

And for most eye injuries, time is of the essence.

"The faster [patients] are seen, the better the outcome," says Dr. Pratap Challa, assistant professor of ophthalmology at Duke Eye Center in Durham, N.C. "They should seek help immediately."

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